Bortezomib

Bortezomib for injection (Velcade™)

  • About Velacade™
  • How is it given?
  • How does it work?
  • What kind of cancer is Velcade™ being used to treat?
  • Possible side effects
  • References

About Velacade™

Velcade™ is a new type of cancer treatment that has been approved in the US for the treatment of patients with multiple myeloma who have had at least two previous types of treatment, but whose myeloma is developing. Velcade™ is a man-made chemical that is being tested in research trials to treat many types of cancers. It has also been called PS341 in the past.

When a drug is being developed it has to go through various stages of research, called clinical trials or studies. These are intended to establish a safe dosage, what side effects the drug may produce and in which cancers it may be useful. They also find out how effective the drug is, and whether it is better than the existing treatments or has extra benefit when given with these drugs. The process of clinical trials is described in more detail in CancerBACUP’s section on cancer research trials (clinical trials).

Many drugs that are thought to be promising may be found not to be as good as existing treatments, or to have side effects that outweigh any benefits. For this reason, doctors and other medical staff carry out frequent and careful checks on the progress of each patient who is taking one of these developmental drugs. If you are taking a developmental drug your doctor will explain all about the drug, the procedures being used, and how you will be looked after while you are taking it. If at any time you have concerns ask your doctor or nurse for information and advice.

Currently, Velcade™ is available only to a small number of people in the UK, usually those taking part in clinical trials. In certain circumstances it may also be given to individual patients who have been selected by their doctor as suitable (this is called a named patient basis).

How is it given?

Velcade™ is given by injection into a vein (intravenously) through a cannula (a fine tube inserted into the vein). It may be given through a central line which is inserted under the skin into a vein near the collarbone, or through a PICC line which is inserted into a vein in the crook of your arm. CancerBACUP has further information about central lines or PICC lines.

Velcade™ is usually given as four doses over a three-week period. The doses are given on the first and fourth day of the first two weeks, followed by a ten-day rest period. This completes one cycle of treatment. You can have up to eight cycles of treatment over six months.

How does it work?

Velcade™ is a new type of anti-cancer drug called a proteosome inhibitor. Proteosomes are a group of enzymes found in all cells in the body. They have an important role in controlling cell function and growth. By interfering with the function of proteosomes Velcade™  may cause cancer cells to die and may stop the cancer from growing. Cancer cells are much more sensitive to the effects of Velcade™ than normal cells are.

What kind of cancer is Velcade™ being used to treat?

In the UK Velcade™ is currently being used in clinical trials to treat a type of cancer called multiple myeloma. It is given to people who have already been treated with at least two other types of chemotherapy, and whose myeloma has continued to develop despite other treatments. Velcade™ is also being used in early trials for other types of cancer.

Possible side effects

As Velcade™ is a relatively new drug, not all the side effects are known. Those that have been reported so far include the following.

Nausea (feeling sick) and vomiting There are now very effective anti-sickness drugs to prevent or greatly reduce nausea and vomiting. If the sickness is not controlled or continues, tell your doctor, who can prescribe other anti-sickness drugs which may be more effective. CancerBACUP has a section on coping with nausea and vomiting.

Fatigue (tiredness and a feeling of weakness)  It is important to allow yourself plenty of time to rest. CancerBACUP has a section on coping with fatigue.

Diarrhoea This can usually be controlled with anti-diarrhoea medicines but let your doctor know if it is severe or continues. It is important to drink plenty of fluids if you have diarrhoea.

Dehydration It is important that you drink plenty of fluids (2–3 litres per day).

Symptoms of a fever  These may include a high temperature and chills. These symptoms can be controlled or reduced with drugs, which your doctor can prescribe for you.

Loss of appetite A dietitian or specialist nurse at your hospital can give advice. CancerBACUP’s section on diet and the cancer patient has tips on boosting appetite, coping with eating difficulties and maintaining weight.

Low platelet count  Platelets help to clot the blood and prevent bleeding. The number of platelets in your blood will be checked regularly. If the number is low you may bruise very easily and may suffer from nosebleeds or bleed more heavily than usual from minor cuts or grazes.

If you develop any unexplained bleeding or bruising you need to contact your doctor or the hospital straight away, and you may need to be admitted to hospital for a platelet transfusions. A fluid containing platelets is given by drip into your blood. These platelets will start to work immediately, to prevent bruising and bleeding.

Numbness or tingling in hands or feet This is due to the effect of Velcade™ on nerves and is known as peripheral neuropathy. You may also notice that you have difficulty doing tasks like doing up buttons. Tell your doctor if you notice any numbness or tingling in your hands or feet. This may improve if the dose of Velcade™ is reduced or if it is stopped. CancerBACUP has information about peripheral neuropathy and how to deal with it.

If you have any questions about these or any other side effects do talk to your doctor or nurse. It is also important to let them know if you have any symptoms or side effects that may be related to the treatment you are having

Patients wishing to enter trials should speak to their cancer specialist, who can advise them whether Velcade™ may be a suitable treatment in their case. Cancer specialists can also advise patients on other cancer treatments which are appropriate for their situation.

For more information contact CancerBACUP’s Cancer Support Service.

References

This section has been compiled using information from a number of reliable sources including the websites of the:

  • Multiple Myeloma Research Foundation
  • National Cancer Institute of America
  • US Food and Drug Administration

For further references, please see the general bibliography.

Bortezomib

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